Tag Archives: process improvement

HR Antiques Road Show

If you are a history buff, or just a hoarder, then you might be a fan of the Antiques Road Show on Public Television. While I’m sure that many of you are familiar with the program, the premise is as follows: the show brings together a variety of experts to a single location where locals can have anything they own appraised, from attic-junk to family heirlooms. Every once in awhile you see a person who made a five-dollar purchase at a garge sale years before with an item that appraises at tens-of-thousands of dollars. Of course, virtually every item that is brought to the Road Show has personal value to the owner; the question is whether that value translates to monetary value for others.

Healthcare Value Network

I spent a couple of days last week in Appleton, Wisconsin with 17 other healthcare HR leaders to learn and share how HR systems and processes can drive real change in a Lean organization. The only things we knew going into the session is that our organizations were part of the Healthcare Value Network, and through some pre-planning we surmised that we were all struggling with similar HR, organization development, and leadership challenges. Our brief time together confirmed these assumptions.

I left the land of the Green Bay Packers with a bag of cheese curds, and a number of key takeaways. However, there is one simple concept – although not a new concept – that has stuck with me more than others: The development of HR systems and processes in a Lean organization occurs in the Gemba, and not in an HR conference room. In non-Lean language, we need to develop our HR approaches with our clinical (operations) leaders and employees. In the end, our work must be redesigned to support what is really needed on the rapidly changing front lines of healthcare.

Get Out of the HR Attic

Our traditional approach to HR administration is that we have done the bulk of our process work and planning behind closed doors, or in the attic. We are the experts in regulatory and compliance matters, organization development constructs, and we have the unrivaled talent to create reams of forms. When we were feeling more “strategic,” we might have included, or sought real input from others outside of the HR kingdom.

When our new systems were defined, and the ink was dry on the new forms, we took the process/system on the business version of the Antiques Road Show. What we often discovered was that the heirloom-quality HR process that we had masterfully created was appraised by operational leaders (experts) to be of little or no value to them, or the work that they were doing. It was easy to become that person on camera at the end of the Antiques Road Show who whined about how unappreciated our process was – at least it was highly valued by us, and we are going to hang onto it.

Strategic HR: Solving Other People’s Real Problems

Strategic HR today, particularly in a Lean sense, means that we are solving our customers’ problems through the ongoing, real-time design of better HR processes and systems. By better I mean: they are intentionally designed to add value to clinical (operational) people and processes, as their needs evolve; they are not mired in meeting the strictest interpretations of government regulations; they are not derailed by an unreasonable aversion to business risk; and, they accomplish what is most needed by the people in the Gemba, and ultimately our customers.

It seems that the only way to accomplish the strategic work of HR in a Lean organization is to design it with the people in the Gemba. So while the “what” is settled in my mind, and the minds of many other Lean healthcare HR leaders, the “how” is an entirely different challenge.

What have you done to engage your operations leaders in redesigning HR systems to meet their needs?

[Photo Credit: anankkml via freedigitalphoto.net]

Baldrige Criteria Recognizes Social Media Strategy

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My organization is entering its seventh year of using the Baldrige National Quality Program criteria as a framework for Performance Excellence. This is a voluntary quality evaluation process administered by the National Institute of Standards and Technology (NIST), which is housed under the U.S. Commerce Department. The program provides specific criteria by which any organization can successfully approach quality, and performance excellence.

The process is about identifying how your organization addresses processes, systems and data. By completing and submitting a narrative application at the Federal level, or at the State level through organizations like the Minnesota Council for Quality, valuable feedback is provided by trained evaluators. According to the program,

On August 20, 1987, President Ronald Reagan signed the Malcolm Baldrige National Quality Improvement Act of 1987, establishing a program that many credit with making quality a national priority and helping to revitalize the U.S. economy during the 1990s…the Baldrige Criteria for Performance Excellence are widely used as an assessment and improvement tool. In 1999, categories for education and health were added to the original three categories: manufacturing, service, and small business. In 2007, a nonprofit category was added.

The criteria organize a Performance Excellence approach in seven categories: Senior Leadership and Governance; Strategic Planning; Customer Focus; Measurement, Analysis, and Knowledge Management; Workforce Focus; Operations Focus; and, Results.

Introducing Social Media

The impetus for this post was a conspicuous change that was made to the crieteria for 2011-2012. Under the Customer Focus category, the criteria introduced the need for successful organizations to identify their strategies for the use of social media and web-based technologies. Here is what the new criteria ask:

Section 3: Customer Focus

Describe how your organization listens to your patients and stakeholders and gains satisfaction and dissatisfaction information. Within your response, include answers to the following questions:

a. Patient and Stakeholder Listening. (1) How do you listen to patients and stakeholders to obtain actionable information? How do your listening methods vary for different patient groups, stakeholder groups, or market segments? How do you use social media and Web-based technologies to listen to patients and stakeholders, as appropriate? [Emphasis added].

So while the debate rages on about how companies should manage their employees’ use of social media in the workplace, the Baldrige Criteria have stepped beyond leadership stonewalling, frantic legal departments, and skeptical HR professionals. It rightfully recognizes that patients (customers), and employees are using social media and web-based technologies, and organizations who are truly interested in listening and getting feedback need to be intentional about their presence in this space.

How does your organization use social media and web-based technologies to listen to your customers? How about your employees?

HR Soot: Even the Government’s quality program gets the value of social media. What are we all waiting for?

Lean HR – Seriously?

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I’ve had a lot of Lean on my feeble mind recently. This area of contemplation is the result of my health care organization being well into a Lean management transformation – I still have a lot to learn. For those of you who are not familiar with Lean, here is how Wikipedia describes it:

Lean Manufacturing or lean production, often simply, “Lean,” is a production practice that considers the expenditure of resources for any goal other than the creation of value for the end customer to be wasteful, and thus a target for elimination. Working from the perspective of the customer who consumes a product or service, “value” is defined as any action or process that a customer would be willing to pay for. Basically, lean is centered on preserving value with less work.

Dwane Lay over at Lean HR Blog has written some great posts about Lean HR principles (and other topics as well). People with whom I speak sometimes look at me cross-eyed when I suggest a Lean HR, or a Lean health care system. What could car manufacturers know about patient care? What does a widget factory know about the complexities of HR? What I’m learning is that the answer to the questions is probably, “nothing.” However, the processes and approaches used to eliminate waste in automobile manufacturing are absolutely relevant to creating value in HR, and health care.

HR is Waste

A question that I am just beginning to ask regarding all HR processes is this: What value does the process/requirement bring to the person I am asking to complete it? Lean, after all is about creating value for the “customer who consumes a product or a service.” So think about it for a minute. Of all of the forms (e.g., requisition forms, evaluation forms, benefit enrollment forms, etc.) and processes that we require of managers, employees and candidates, which of them add value, and which would they be willing to pay us money for the value that the process is designed to create? If you think about it long enough, and you are completely honest, the answer to the question is probably, “NONE.” In Lean terms, HR processes are largely waste.

Time to Eliminate HR?

I’m not confident that operations people would put up much of an argument about HR processes really adding value to the day-to-day work that they do. So why should HR exist?

I’ve been told that good HR practitioners solve real, sticky, ugly and contentious people problems in their organizations. When they are really good, they plan ahead and create systems and processes to avoid the problems to the greatest extent possible (we are still dealing with humans). The things that managers and employees value from HR typically do not need an enrollment form, an executive approval, pre-authorization, or an annual election. So why do we spend so much time creating so many requirements? I did a guest rant on Xpert HR in which I suggest that we have effectively become data whores, and that it is time for HR to start focussing on people.

A Lean Mean HR Machine

At what point will HR begin to get rid of all of the paperwork, barriers, red tape, signatures and other requirements that are not absolutely necessary for regulatory compliance, or great business management (see Compliance Police)? Those things that are absolutely necessary, but still non-value adding need to redesigned to create some value to those required to comply with the demand.

In the HR trenches we often complain about having to deal with all of the ugly people problems that result from bad management practices – if everyone only followed the processes that have been developed… But, perhaps the real value of HR lies directly in our ability to effectively manage the HR soot that we compulsively work to avoid. We are in the business of leading people. So maybe the way we conduct our business should be focussed more on what value they need from us.

What do you think?